Commentary: A Public-Private Health Care Partnership

By Douglas E. Schoen

A recent poll from CBS News found that the tightening economy is forcing people to make some tough choices. Alarmingly, these kinds of decisions are spilling over into an area where they don’t belong– health care. More than one in three Americans is delaying care. Around 30 percent are skipping screenings, tests, and other treatments. And 27 percent aren’t filling their prescriptions.
In the most advanced and wealthiest nation on earth, people should never have to make these kinds of choices with their health. It’s as clear a sign as any that our current healthcare system is overdue for an overhaul– and I’ve spent over 30 years analyzing opinion polls.

But fixing our broken healthcare system presents a huge challenge– one that can’t be solved through partisan politics. If it could, we’d have fixed the problem long ago.
The simple fact is, neither side has the complete answer. As a centrist committed to nonpartisan solutions, I’d like to offer some middle-of-the-road approaches that bear serious consideration.
First, we need a renewed emphasis on disease prevention. Promoting wellness and healthy lifestyles is a lot cheaper than paying for someone’s hospital care. Prevention campaigns, like those spearheaded by Mayor Bloomberg in New York, will pay huge dividends in the future for everyone.
The obesity epidemic, for example, is ravaging the nation– the Centers for Disease Control estimate more than one-third of all adult Americans are obese. Obesity drives up healthcare spending and costs untold billions of dollars in lost productivity.
Fighting obesity, particularly in children, will, in the long run, reduce healthcare costs and strengthen our economy. But it will require a joint public-private approach just like the successful efforts to reduce and curb smoking.
Public and private partnerships shouldn’t end there. While most Americans agree that the eventual goal of healthcare reform should be universal coverage– that is, health insurance for all– there is more than one way to get there. The political right generally opposes completely government-run health care, and the left distrusts the private sector to get the job done by itself.
But a public-private partnership, similar to the very successful and lauded healthcare systems in the Netherlands and Switzerland, may strike the right balance between privately organized but publicly guaranteed health insurance.
Our government already has effective programs in place to identify and enroll the 12 million Americans currently without any health insurance yet eligible for Medicaid and the State Children’s Health Insurance Program. But only privately run insurance plans have the experience, ability, and impetus to push the healthcare system forward to innovate and adapt. Indeed, the insurance industry is ideally positioned to address the uninsured crisis.
Government can also create new pooling mechanisms to extend health insurance to the self-employed, small businesses and the poor, and private health plans should compete for the business of those groups, working to generate both affordability and expanded access.
Government alone can’t solve these problems. Nor can private industry. But working together, we can find the right innovation and infrastructure to effectively reform the system. From a renewed emphasis on prevention, early detection, and intervention to expanding the public safety net that will catch the neediest members of our society.
The healthcare crisis is not some incurable disease. It can be treated– jointly– with the best of private industry and the best of public programs.

Douglas E. Schoen was a campaign consultant for more than 30 years and is the author of Declaring Independence: The Beginning of the End of the Two-Party System.

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